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Individual

MRS. LACEY EVONE-KIM MUENTER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
810 E 21ST ST, SUITE 6A, CLOVIS, NM 88101-4442
(575) 763-9517
Mailing address
810 E 21ST ST, SUITE 6A, CLOVIS, NM 88101-4442

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
A-0706
NM

Other

Enumeration date
12/15/2009
Last updated
12/15/2009
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